Active NPI
Rocky Ray Deswood
- Technician
- Polacca, AZ
National Provider Identifier
1659870277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Technician
- License
- 891542
- Practice address
- Hwy 264 Mile Post 388
Polacca, AZ 86042-4000 - Phone
- (928) 737-6232
- NPI assigned
- Feb 9, 2018
- Last updated
- Feb 9, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Technician | 374700000X | 891542 | AZ | Primary |
Addresses
Primary practice location
Hwy 264 Mile Post 388
Polacca, AZ 86042-4000
Mailing address
PO Box 4000
Polacca, AZ 86042-4000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020529 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 891542 | AZ | MD | Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518134400000",
"number": "1659870277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4000",
"city": "POLACCA",
"state": "AZ",
"postal_code": "860424000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HWY 264 MILE POST 388",
"city": "POLACCA",
"state": "AZ",
"postal_code": "860424000",
"telephone_number": "928-737-6232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESWOOD",
"first_name": "ROCKY",
"middle_name": "RAY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-02-09",
"last_updated": "2018-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "374700000X",
"taxonomy_group": "",
"desc": "Technician",
"state": "AZ",
"license": "891542",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "020529",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Polacca, AZ
- Korel Leshaun Chisley, PHARMD
- Valerie Cline, RN, MSN
- Emma Guadalupe Cortez
- Kiley Marissa Cox, RN
- Tracy Denet
- DHHS IHS Phoenix Area (Hopi Health Care Center)
- DHHS IHS Phoenix Area (Hopi Health Care Center)
- DHHS IHS Phoenix Area (Hopi Health Care Center)
- DHHS IHS Phoenix Area (Hopi Health Care Center)
- Alison Dion, PHARMD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.